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Sunday, April 13, 2008

SOUND OFF: DRUGS AND THE DOCTORS WHO PITCH THEM

[Note: Dr. Robert Jarvik has responded to this question via e-mail. His e-mail is posted in the comments section for this blog post.]

Pfizer has dropped Dr. Robert Jarvik, inventor of the artificial heart, as a spokesman for Lipitor, its cholesterol-lowering medication. The rub, apparently, was that, while Jarvik has a medical degree, he is not licensed to practice medicine. Some believe that this might be misleading to viewers of the Lipitor ads, since Jarvik appears to be giving medical advice.

Fuel was added to the issue after The New York Times reported that one of the ads featuring a rower who seemed to be Jarvik was actually a stunt double. Congressional leaders took issue with the ads, and Pfizer decided to dump Jarvik.

Was Pfizer wrong to use Jarvik in the Lipitor ads? Was there merit to the criticism that he shouldn't be pitching the product because he doesn't hold a medical license? Did Pfizer make the right decision to drop Jarvik as a Lipitor spokesman?

Post your thoughts here by clicking on "comments" or "post a comment" below. Please include your name, hometown, and state, province, or country. Readers' comments may appear in an upcoming column. Or e-mail your comments to me at rightthing@nytimes.com.

Jeffrey L. Seglin, author of The Right Thing: Conscience, Profit and Personal Responsibility in Today's Business (Smith Kerr, 2006), is an associate professor at Emerson College in Boston, where he teaches writing and ethics. He is also the administrator of The Right Thing, a Web log focused on ethical issues.

Do you have ethical questions that you need answered? Send them to rightthing@nytimes.com or to "The Right Thing," The New York Times Syndicate, 500 Seventh Avenue, 8th floor, New York, NY 10018. Please remember to tell me who you are, where you're from, as well as where you read the column.

c.2008 The New York Times Syndicate (Distributed by The New York Times Syndicate)

7 comments:

Anonymous said...

I didn’t realize this had happened. I found it demeaning that the man who invented the artificial heart to lower himself and the profession by touting a product as good as it may be.

George

Anonymous said...

Dr. Jarvik? Anyone dumb enough to believe that the people in commercials are real and are who they say they are, are dumb enough to buy the products advertised.

Burl Estes
Mission Viejo, CA

Anonymous said...

I was amused at the "sound off: drugs , and doctors who pitch them" because I thought the heading referred to physicians recommending a drug to a patient in the office. But, this article actually was referring to a scientist, Dr. Jarvik who takes Lipitor and has had positive results. In my opinion removing Dr. Jarvik from the ad was unnecessary. To me there is no difference between Dr. Jarvik a scientist, or Joe Smith a fire fighter or President Bush stating that Lipitor has had positive results in lowering cholesterol. Dr. Jarvik would probably have done more research as far as the various cholesterol lowering drugs than the lay people.
What I find unethical is when a physician pushes a drug after being wined and dined by a sales representative without in depth research of options that didn't wine and dine the doctor.
Helen Homer
Santa Ana, CA
The Orange County Register

Jeffrey L. Seglin said...

I received the following e-mail from Dr. Jarvik on April 14, and thought his comments might add to the discussion of the questions I asked readers to reflect on and repsond to in the column this week:

Mr. Seglin:

I was interested in your solicitation of comments on the ethics of the Lipitor ads in which I appeared. The limited information your readers have doesn't permit them to do much more than give a first impression of the issue. I hope I can help by providing some additional background.

The information I presented about Lipitor was 100% truthful and in conformity with the FDA labeling of Lipitor. This means that the information was scientifically valid based on large clinical studies and an extensive review by numerous experts.

I am well known to the public as an artificial heart inventor and heart expert. I was clearly identified with artificial heart development in each ad, and was never shown in a doctor’s office or hospital setting, even though in my professional activities I often work in hospitals, and frequently work with cardiologists and heart surgeons from leading medical centers around the world.

In the ads I do not give medical advice. I recommend that patients ask their doctors about Lipitor. Even though some people might mistakenly consider the information I communicate to be medical advice, it is not; because I never state that any patient, with even the highest risk, should do anything but talk with their doctor.

Regarding the issue of my credentials, I have broad knowledge and special expertise about heart disease, the suffering it causes, and the unavailability of satisfactory treatments for advanced heart failure. I know better than most how important it is to prevent heart disease and I have the solid scientific background to be an advocate for prevention.

There is no legal requirement for a person to hold a medical license in order to advertise medications. I am president of a manufacturing company that researches and produces artificial hearts, which was the career path I chose decades ago, rather than practicing medicine.

Pfizer is entirely within its legal rights to choose whomever it sees fit to be spokesperson for its advertising. My credentials as an M.D., as a heart expert, and as a leading artificial heart inventor, are all reasonable qualifications supporting Pfizer’s choice for spokesman. The exact scientific information that the law allows DTC ads of prescription medications to convey to the public is strictly limited to the FDA labeling. The spokesperson is a communicator, not a medical decision maker, and the public well understands that role.

There is no other heart medication in history that has received such extensive support from medical practitioners, and that is why Lipitor became the most widely prescribed drug in the world, with more than 144 Million patient years of use.

In my opinion Pfizer was wrong to capitulate to political pressure and the unfavorable publicity it generated. The Lipitor ad campaign was truthful and tasteful. I believe it motivated hundreds of thousands of new patients to see their doctors; patients who never before had treatment for their high cholesterol. Many heart attacks and strokes will be prevented, and many people will avoid the disaster that otherwise awaited them.

It is a sad commentary that Pfizer, a company with vast contributions to public health, should be criticized as deceptive because I didn’t row a boat in the first ad.

I was not permitted to row on that cold mountain lake in winter, because there was a real danger of drowning in the frigid water in the event of an accident. But subsequent to all the fuss, I have rowed exactly the same type of racing shell that was featured in the ad, and could have done it at the time with coaching as originally planned. I was told that the insurance company refused to let me row.

The use of experienced professionals to film dangerous scenes is standard in the industry. Calling this deception is no more than an expression of bias.

So what’s the bottom line on the ethics? We’ll see what your readers say.

My judgment is that the ads were ethical but some of the press was misleading.


Robert Jarvik, MD.
New York, New York

Anonymous said...

I lay this at the door of the ad agency who thought that a company like Pfizer required a boost in its credibility by a notable like Dr. Jarvik. The fact that he decided to do this may be financial or it may be in the interest of good public health as he states. I for one have had bad experiences with statins so my stomach twisted when I saw the ad. Maybe bad press IS finally getting to Pfizer so their credibility DOES indeed now need such a boost!

Anonymous said...

I have no problem with the Lipitor ads showing an endorsement by Dr Jarvik. I found them informative and professional - even now after hearing of the stunt double and non-current medical license of Dr Jarvik. In Dr Jarvik's case, it is the reputation and endorsement of someone who knows something about hearts which make the ad credible. As long as he really invented the successful artificial heart, it does not matter if he ever had a license to practice Medicine.

However, in cases of unknown subject matter exerts who rely not on their accomplishments, but their title, this is an ethical concern. Also of ethical concern is the use of a non-theatrical stunt double being included in a non-fictional endorsement. The rowing had nothing to do with the crdibility of Dr Jarvik's endorsement, but should not have been used.

Bill Wotring
Fullerton, California

Carroll Straus said...

I have to agree with Dr. Jarvik-- he did nothing unethical. I have seen the ads-- I ignored them as i do ALL drug ads. I am aware of the research that says statins benefot people-- but I do not plan to join the crowd and take them. I feel it is our lifestyles that cause most of the diseases the "big Pharma" folks get rich from, and i guess I am also lucky. I come from a long line of people who didn't take pills.

But was the ad unethical? No. Worth fussing about? I only wish! We have FAR larger problems in this world!